The author instructed a graduate-level health psychology research methods course designed to be COVID-safe for students regardless of health vulnerabilities and assessed safety knowledge, attitudes, behaviors, perceptions of inclusivity, and course evaluations. The methods describe the course content, communication regarding COVID-19 precautions in a pre-semester email and the syllabus, a COVID-19 educational video, in-class precautions, measures, and analyses. The author’s university Institutional Review Board approved the project as post-hoc analyses of deidentified course data (IRB#: 2023 − 1136).
Course Description
A tenured Health Psychology PhD program director teaches this health psychology research methods course, “Clinical and Community-Based Research Methods.” Students span health psychology, school psychology, and social psychology doctoral programs, a terminal master’s program in behavioral health, and occasionally advanced undergraduates who will begin graduate training in the fall. The course aims to equip students with the knowledge and skills needed to design and execute psychosocial studies in communities, therapy clinics, schools, medical centers, and similar settings. Course content focuses on research topic identification, literature review, big-picture methodologic decisions in experimental design, nuts-and-bolts of implementing experiments (e.g., protocol delineation, randomization, recruitment, retention, and fidelity monitoring), complex experimental design, quasi-experiments, observational studies, program evaluation, community-based participatory research, measurement reliability and validity, scale development, career development, cultural humility, budgeting, publishing, and grant funding. Major assignments include weekly discussion papers based on readings, an exam, a randomized controlled trial (RCT) protocol, and protocol presentations. The course combines readings, lectures, discussion, and independent protocol design with moderate mentorship.
COVID-19 Precautions
Communication about COVID-19 Precautions
As depicted in Fig. 1, the course was designed to be safe and inclusive to all students regardless of health status, even during a hypothetical COVID-19 surge. Before the start of the spring semester, the instructor emailed all enrolled students to orient them to the planned COVID-19 precautions grounded in safety and inclusivity and requested any feedback. The course syllabus detailed expectations regarding classroom health and safety precautions (see Fig. 1, bottom), and the instructor and students addressed any nuanced considerations through email and classroom dialogue.
COVID-19 Safety Video
Before the first day of class, students were required to complete a pre-test on COVID-19 safety knowledge, watch a 40-minute video presentation by the instructor on COVID-19 safety, and complete a post-test identical to the pre-test. The video topics are noted in Fig. 1 (middle) and are grounded in the instructor’s substantial expertise in COVID-19 mitigation in community-based and medical settings (Hoerger, Gerhart, et al., 2023; Hoerger et al., In press; Hoerger, Kim, et al., 2023). The instructor also disseminated the video on social media, viewed over 30,000 times. Students completed the knowledge test again at two-months follow-up into the course.
In-Class COVID-19 Precautions
In-classroom COVID-19 mitigation was substantial. High-quality masks (N95, KN95, or KF94) were required to be worn correctly in the classroom at all times. Students were requested to leave the classroom at any time if needing a food or beverage break, and the instructor provided universal breaks. The instructor noted only three lapses in masking, with one student sipping water once and one student twice having their nose outside their N95. On the first day of class, the instructor provided each student with a sample pack of five models of N95 masks. From largest to smallest, these include the 3M VFlex 9105, Aegle flat-fold, 3M Aura 9210, Vitacore CAN99, and 3M VFlex 9105S (see Fig. 2a). At the time, the purchase price of the masks ranged from approximately $0.60-$2.00 USD per mask (about $5 total per pack), though comparable versions of the 3M VFlex models (specifically, the VFLex 1804 and 1804S) have dropped in price recently to as little as $0.07 USD. The instructor provided students with more N95 masks throughout the course for free as desired. Students could also obtain their own masks. The instructor selected a classroom in the engineering building that he tested and knew to have excellent ventilation and was oversized to allow distancing. As a class project the first day, students built four DIY air cleaners, variously referred to as Corsi-Rosenthal Boxes or SAFE air purifiers (Dal Porto et al., 2022; Dodson et al., 2022; Srikrishna, 2022) using box fans, duct tape, and MERV-13 HVAC filters, provided by the instructor (see Fig. 2b). Students assisted the instructor in calculating the air cleaning rate in the classroom, estimated at 15 air changes per hour (ACH), approximately equivalent to the minimum standard of a U.S. operating room (Centers for Disease Control and Prevention (CDC), 2022). Air quality was also monitored periodically throughout the course using an Aranet4 monitor (see Fig. 2c), which assesses outdoor air ventilation from the HVAC system to ensure it is functioning correctly. Students were requested to attend remotely if exposed to COVID-19, ill for any reason, or simply being health cautious. Policies related to personal illness, family illness, and bereavement were flexible.
Participants
Eleven students were enrolled in the course and completed the evaluation outcome measures.
Measures
COVID-19 Safety Knowledge
Students completed a test of COVID-19 safety knowledge at baseline (pre-test), after watching the COVID-19 safety video (post-test), and two months later (follow-up). The test included 10 multiple-choice questions, each with 3 response options. Responses were scored dichotomously as correct or incorrect. Possible scores ranged from 0-100% correct.
Attitudes and Behavior
At two months follow-up, participants answered 14 questions about their COVID-19 safety attitudes and behavior. Questions examined whether students 1) changed masking behavior (trying different types of N95s in the variety pack, talking to someone else about N95s, wearing an N95 for the first time, or switching N95s for better fit), 2) promoted indoor air quality to reduce COVID-19 transmission (talking to someone about Corsi-Rosenthal Boxes, giving information on how to build them, talking to someone about HEPA filters, buying a HEPA filter, or buying an air quality monitor), 3) changed testing behavior (helping someone decide what to do about testing, changing personal testing protocols), 4) helped others handle high-risk situations (being safer in high-risk contexts, or reducing in-home transmission when someone is ill), and 5) helped others to understand Long COVID.
Perceptions of Inclusivity
At two months follow-up, students answered four questions about the health-inclusivity of the course. They rated (0-100%) the chances they believed COVID-19 was transmitted in the current course versus in other typical courses during the current and prior semester (fall 2022 and spring 2023). They also rated (0-100%) the chances they believed a student who was immunocompromised or chronically ill would be comfortable in the current course versus a typical course in the current or prior semester.
Course Evaluations
Each student completed a course evaluation survey with 11 ratings on a scale from 1 (strongly disagree) to 5 (strongly agree). For example, “Overall, I would recommend this course.” The relevance of each rating varies by course, so the instructor also conducted analyses of 5 target questions selected a priori as most relevant to this methodology course: recommending the course, recommending the instructor, meaningfulness of feedback, perceived learning, and perceived knowledge gain.
Analyses
Analyses were conducted in Excel and IBM SPSS Statistics 27.0. Descriptive statistics were used to summarize each variable. For knowledge, between-group t-tests were used to compare the percentage correct at baseline versus post-test or follow-up; repeated-measures t-test could not be used, as student-level data were not linked longitudinally, so the analysis was conservative. For course evaluations, analyses reported means and the percentage of ratings that were at least 4 out of 5, both for the 11 total questions and the 5 target questions; a sign test was used to test whether the proportion of ratings of ≥ 4 differed from the proportion of ratings that were ≤ 3. Inferential analyses used a two-tailed alpha level of .05. The underlying data are available from the corresponding author upon request.